MEDICARE: MR. PAUL IME INYANG LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1548425440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL IME INYANG LPC

Provider Business Mailing Address
First Line	:	1409 KEUKA CT
Second Line	:
City	:	ODENTON
State	:	MD
Zip	:	21113-3684
Country	:	US
Telephone Number	:	301-509-6077
Fax Number	:

Provider Business Practice Location Address
First Line	:	2027 MARTIN LUTHER KING JR AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-7007
Country	:	US
Telephone Number	:	202-800-4387
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2008
Last Update Date	:	04/08/2024

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